Robert Oakley, St George’s University Hospitals NHS Foundation Trust
I wish to develop my clinical career around antimicrobials/therapeutic drug monitoring (TDM) and undertake associated doctoral/post-doctoral study in this area. I see an exciting gap as a pharmacist, to utilise novel technologies to improve these substantial components of many patients’ care. My informed interest is in reducing inter-patient variability in therapeutic response to vancomycin and associated acute-kidney-injury (AKI) in intensive care unit (ICU) patients. I hypothesise that the vancomycin ‘area-under-the-blood-concentration-curve’ (AUC) TDM methodology is superior to ‘blood-trough-concentration’ TDM in guiding precision dosing in ICU patients, which will optimise clinical outcomes. I also envisage that AUC TDM data can be statistically processed to problem-solve variability issues through TDM personalisation.
The part-time MSc in Translational Medicine, provides me with a foundation in essential
programming/population-statistics/antimicrobial-personalisation/research-training. This will equip me with the skills needed to design a PhD proposal consisting of a multicentre definitive study and TDM statistical model development.
My host organisation is sponsoring my associated MSc observational study (Appendix 1) to assess feasibility of collection/analysis of paediatric/adult ICU pharmacokinetic and clinical outcome data associated with vancomycin AUC/trough TDM methods. Non-invasively taken blood is readily available to assay in the ICU setting to obtain relevant vancomycin TDM data. I am studying a manageable sample size (twenty-four patients) given time pressures and my availability as sole data collector. Calculations of the standard effect size from AKI/treatment-success outcome data and estimates of an attainable population parameter (to scope an appropriately powered definitive study sample size), will be explored as part of my research project. Please see Appendix 1, which outlines a detailed methodology and considerations which ensure my project aligns with Good Clinical Practice recommendations. This includes details of an Integrated Research Application Service (IRAS) application I am making, to provide assurance that my proposal is safe, plus scientifically and ethically sound. The proposal has been approved locally and a Schedule of Events Costs Attribution Template (SoECAT) has been completed.